Purpose: To evaluate the morphological
changes of the Meibomian glands in patients with evaporative “dry eye” compared
to normal subjects by in vivo laser scanning confocal microscopy (LSCM). To
correlate these changes to the clinical observations and tear functions.
Methods: The study was based on
trans-tarsal images of 30 normal and 30 diseased lids (patients with subjective
complaints and objective symptoms of evaporative “dry eye”). Each participant was examined by
in vivo LSCM (HRT3 Rostock corneal module). The results were compared to
histological findings of normal or pathologically changed Meibomian glands.
Results: Patients with evaporative “dry eye” presented with destructive changes of the Meibomian
glands as follows: occlusion of the lumen, impaired morphology of the acines,
lack of normal structure and infiltration with inflammatory cells. Reported
ocular surface and tear function abnormalities were correlated to the Meibomian
glands dysfunction (MGD). In all cases the lid hygiene and anti-inflammatory
treatment demonstrated tendency to restoration of the structure.
Cоnclusion: In vivo LSCM can effectively
demonstrate the morphological changes of the Meibomian glands in patients with
evaporative dry eye symptoms. This noninvasive technology is useful as a
supplementary diagnostic tool for in vivo assessment of the histopathology of
many ocular surface disorders and monitoring of the therapeutic effect in
patients with MGD. Glandular acinar density and acinar unit diameter seemed to
be promising new parameters of Meibomian glands in vivo confocal microscopy.
The examination has the potential to change the evaporative dry eye treatment
Uploaded by IMJ Health on